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It occurs in young men from severe athletic effort; it occurs in older persons from some severe muscle strain, and it may even occur from so simple an effort as rapid walking by one who is otherwise diseased and whose heart is unable to sustain even this extra work. All of the conditions which have been enumerated as causing simple hypertrophy may have dilatation as a sequence.
The breast admits only of two motions of dilatation, when it draws from the lungs the breath, and of contraction, when it returns what it did receive. The Stoics say that all the passions are seated in those parts of the body which are affected, the senses have their residence in the commanding part of the soul.
If the condition is developed from a myocarditis or from fatty degeneration of the heart, it may be impossible to cause the left ventricle to improve so much as to overcome this relative dilatation or relative insufficiency of the valve.
Again the marine dilatation tossed him against a rock, and again he anchored himself to it with an instinctive clutch of his hands. But before this wave retired it hurled him desperately upon another ledge, the refluent water passing back below him.
The tension thrown on the heart during labor is always severe, and has not infrequently caused acute heart failure by causing acute dilatation, and in these damaged hearts tediousness and severe, intense exertion should not be allowed. Proper anesthetics and proper instrumentation should be inaugurated early.
The last theoretical condition would be, excitement of the brain or spinal cord, in a manner analogous to what may be determined by a galvanic current, and followed, therefore, by the same consequence paralysis of vaso-motor nerves, and excessive dilatation of the blood-vessels.
But he was too proud to ask pardon for them. As for the old man, he stood silent for a long time, looking down at the boy, who looked not up again at him. And there was a tremor in his lip, and a dilatation in his eye, which at length grew misty with a tear that gathered, but did not fall. And with a sigh, he turned away. "Well, be it so!" Frank heard him say, as if to himself.
There was a similar case in the Hopital St. Louis, in Paris, in 1829; but in this case the child was born alive five minutes after death. Squire tells of a case in which the mother died of dilatation of the aorta, and in from twenty to thirty minutes the child was saved.
While it is denied that acute dilatation can occur in a sound heart, at the latter end of a serious illness the heart is never sound, and acute dilatation can most readily occur, though fortunately it is generally preventable.
Sooner or later these irritants cause kidney irritation, and chronic interstitial nephritis may develop. just which process becomes the farthest advanced and finally kills the patient is an individual proposition and cannot be foretold. The finale may be cirrhosis of the liver, uremia, arteriosclerosis, apoplexy or myocarditis with dilatation or coronary disease.
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